Hemodynamic Monitoring Flashcards

In a patient with cardiac tamponade, which hemodynamic pattern is classically observed?

Answer: Equalization of diastolic pressures in all cardiac chambers

Cardiac tamponade causes equalization of right atrial, right ventricular diastolic, pulmonary artery diastolic, and PCWP pressures due to external compression.

Which condition is most associated with an elevated pulmonary vascular resistance (PVR) with a normal PCWP?

Answer: Primary pulmonary hypertension

Primary pulmonary hypertension elevates PVR due to intrinsic pulmonary vascular disease while PCWP remains normal, distinguishing it from left-sided causes.

Normal mixed venous oxygen saturation (SvO₂) is approximately:

Answer: 60–75%

Normal SvO₂ from the pulmonary artery is 60–75%, reflecting the balance between oxygen delivery and consumption by peripheral tissues.

A patient's SvO₂ suddenly drops from 70% to 48%. Which condition should be suspected FIRST?

Answer: Decreased cardiac output

A sudden SvO₂ drop most commonly indicates reduced cardiac output, causing tissues to extract more oxygen from a diminished supply.

Which hemodynamic profile is consistent with hypovolemic shock?

Answer: Low CVP, low PCWP, low CO, high SVR

Hypovolemic shock produces low filling pressures (CVP, PCWP), reduced cardiac output, and compensatory vasoconstriction (high SVR).

The 'v' wave in the pulmonary artery wedge (PCWP) tracing represents:

Answer: Passive ventricular filling with mitral valve open

The 'v' wave reflects passive filling of the left atrium during ventricular systole while the mitral valve is closed.

Pulse pressure variation (PPV) >13% during mechanical ventilation most reliably predicts:

Answer: Fluid responsiveness

PPV >13% in mechanically ventilated patients indicates significant preload dependence, predicting that cardiac output will increase with fluid administration.